'What I Learned in My Mom's Final Hours'

Find out the profound lessons writer Mary Hogan experienced amid her family loss

Find out the profound lessons writer Mary Hogan experienced amid her family loss

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Lasting Lessons

It was raining in New York when my mother's caretaker called me from Southern California. My heart sank—the day I'd been dreading had arrived. Mom, 87, in the end stage of kidney disease, had had a heart attack and a stroke on the same day. "I'm on my way," I said, desperately hoping she would hang on until I got there.

For the previous two years, managing my mother's care from 3,000 miles away had been my second job. Diane, my older sister, had died of breast cancer in 2010; my father had walked out years ago, and my three brothers were, well, brothers. Mom was my responsibility, and I supported her emotionally, financially and sometimes, I'll admit, resentfully.

She'd been unwell for years but had not taken care of herself—not until, at 86, she finally resolved to tackle her weight, arthritis, osteoporosis, heart and kidney disease by riding a stationary bike for 20 minutes a day. "The time just flies by!" she would say to me on the phone, awash in endorphins. Then she would reward herself with a Pepperidge Farm Chocolate Chunk cookie from the bag she kept in her underwear drawer.

My mom, while funny and loving, was always a Scarlett O'Hara type: "I'll take care of it tomorrow." But in her final years, it became clear that her "tomorrow" was me, my husband and our savings account. What could I do? She was my mom. I gritted my teeth and wrote checks.

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The Promise

When I arrived in Los Angeles, Mom was unconscious and under 24-hour home hospice care. Her eyes were closed and her mouth open, a liquid morphine dropper under her tongue. Mom's nurse greeted me and gently told me that Mom wasn't in pain, but her body was breaking down. "Hearing is the last sense to go," she said. "She needs to hear that you will be OK without her."

I nodded and sat next to the bed, leaning close to her ear. "I love you, Mom," I said.

Then I stopped, unable to think of what to say next. The uncomfortable truth was that our relationship, never perfect, had become strained after my sister's death. I was exhausted by my mom's neediness and I felt abandoned by Diane's abrupt exit from our lives.

Diane's diagnosis had stunned us all. She'd always seemed invincible: pretty, thin and married to the perfect man with three beautiful children. Her life glowed around its edges. Of course she'd survive, we all thought. And she did—until her breast cancer metastasized into her lungs and liver.

"Don't tell Mom," she commanded me when she got the news that it had spread.

"But—"

"Promise."

I promised. And I didn't tell. To my eternal regret, I believed Diane every time she said, "I'll be fine. My doctors are trying this and that." I never noticed how sick she looked. Neither did my mother. Denial, I now see, is a cataract. A year later when Diane's husband called to say she had passed away, I was stunned.

"What happened?" I sputtered. Though, of course, I knew.

"You'll tell your mother?"

My stomach twisted into a knot. How could I tell my mother that her daughter died without a goodbye? That phone call to my mom was the worst moment of my life.

"How could she not tell me?" Mom sobbed when I confessed that I'd known that Diane's cancer had spread. "I'm her mother. How could you not tell me what you knew?"

I had no good answer. In fact, I had questions of my own. What kind of awful sister had I been that Diane would opt to slip out the back door of life? Didn't she want to tell me and my mother how much we'd meant to her and give us the chance to say the same? In the months after, Mom and I were tortured by it: What had we done that she didn't want our support? Didn't she love us?

At my mom's bedside, her nurse prodded me back to the present. "Release her," she said, and then had the grace to leave the room.

Taking my mother's hand, I tried again. Her warm skin was so achingly familiar I had to press my other hand against my chest to keep my heart from breaking into pieces. I wanted my mommy back. I longed for her to wake up and ask me to sneak her a cookie.

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The Release

"I'll feel lonely without you," I said in a quivering voice. "I'll miss you. When I walk Lucy, I'll think of you." My daily dog walk had been our phone time to laugh and commiserate over the crappiness of getting old. In the last few months, I'd done a little "releasing" of my own. Instead of focusing on her imperfections as a mother, I worked at being a better daughter. Gradually, my impatience morphed into empathy. "We've been through a lot, Mom," I said.

I thought of our difficult talk about signing a do not resuscitate order. "I want God to decide when I die," she declared. "OK," I fumbled on, "but do you think God wants you on a ventilator?" Mom shrugged it off. Weeks later, however, after briefly choking on a blob of melted cheese at a Mexican restaurant—not even remotely on her kidney diet—it occurred to her that a feeding tube would be unbearable, and she signed the DNR. Sitting at her bedside now, as the California sun set, I knew it was the right decision.

"Always, Mom, you will be in my heart," I told her. Then I promised to take care of my brothers and held my breath waiting for her last breath…which didn't come.

The next day, my brothers arrived and we sat around her bed telling her our funniest memories.

"Remember that time we all got sunburned in San Diego, Mom?"

"Remember when I rode that 10-speed down a hill and crashed?"

We said we were fine, that it was OK to let go. We kissed her. This, surely, was what she'd been holding on for, I thought. What God was waiting for. But I was wrong.

On Day Three, we joked that we were in a reality show called Bedwatch. (As often happens, dark humor kept us going.) By Day Four—God forgive me—I thought, "Mom isn't waiting for Dad, is she? If she thinks he'll apologize for being a crummy husband, we'll never get out of here."

That night, I sat alone listening to my mother's labored breaths. What more could I do to help her let go? I ran down the list: "The kids and grandkids are all OK, we love you, you're about to see Diane in heav—" It hit me. Diane. The one that got away. Mom and I had often discussed what we would have done had we known her life was ending. Mom felt as guilty as I did.

Praying that I wouldn't go to hell for what I was about to do, I took Mom's hand and said in my sister's voice, "It's me, Mom. Diane. I've come back to apologize." Tears ran in a river down my face. "I was wrong not to say goodbye," I whispered. "Please forgive me. If I could do it over, I'd have you with me as I am now here with you."

Hand to God, I felt something relax in my mother's body and a blanket of peace descended upon me. I suddenly understood that Diane deserved to die the way she wanted to—quietly and privately—without us all staring at her, and I no longer felt guilty. My sister's death was about her. Not me. Not Mom.

My mother passed away at five the next morning. She looked quiet, at peace. While waiting for the mortuary, my siblings and I drank coffee at the foot of her bed and laughed about the time Mom's high heel got caught on the gas pedal as we careened around the airport.

"Remember, Mom?" I asked. She didn't have to answer. I knew she did.

Mary Hogan is the author of the novel Two Sisters (published March 4, 2014).

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